Perceptions of Distress in Women with Ovarian Cancer.

PURPOSE/OBJECTIVES: To explore women's experience of distress by asking "What do women with ovarian cancer want their spouse or significant other, family, friends, and healthcare providers to know about their experience of distress during diagnosis and treatment?" RESEARCH APPROACH: Modified Glaserian grounded theory. SETTING: An urban setting in the Mid-Atlantic region of the United States. PARTICIPANTS: 12 women, aged 21-71 years, diagnosed with and treated for ovarian cancer. METHODOLOGIC APPROACH: Constant comparative analysis of data obtained by audio recorded interviews. FINDINGS: Although individual experiences differed, abstraction and conceptualization of the data supported a theory of existential assault. Participants found that the diagnosis was shocking and came "out of the blue like lightning." Their responses included seeking the best physician and treatment available, described as "no stone left unturned." Information about the disease was welcomed and unwelcomed as they shared the experience of "knowing what I don't want to know and not knowing what I want to know," and then had the added experience of sharing that information with those in their social network. Interpersonal interactions were described as "watching you watching me--we are both afraid," and "talking yet not talking about death," resulting in relationship changes and the realization that "now I have to take care of me." CONCLUSIONS: Participants experienced diagnosis with and treatment for ovarian cancer as an existential assault that, with the potential for an early death, affected the individual and her relationships. INTERPRETATION: Previous studies have suggested that women diagnosed with and treated for ovarian cancer experience distress. This study reports women's perceptions of their own distress.

Department of health and human services changes: implications for hospital social workers.

In April 2010, President Obama issued a directive to the Secretary of Health and Human Services (HHS) regarding patient visitation, advance directives, and other initiatives to improve the lives of lesbian, gay, bisexual, and transgender people and their families. The HHS response to this directive has implications for hospital social workers. The purpose of this secondary data analysis was to explore indicators of social work readiness to support implementation of the resulting initiatives. A historical context for the changes is provided, inclusive of the cases that spurred the presidential memorandum. The findings are presented within the framework of the profession's standards for social work practice in health care and end-of-life care. Recommendations for enhancing social work readiness for a critical role in implementation of the new regulations are presented.

Stacked stigma: oncology social workers' perceptions of the lung cancer experience.

This study explores stigma in the lung cancer experience by interviewing 18 oncology social workers employed at cancer centers across the United States who provide care to people diagnosed with lung cancer and their family members. A content analysis of the interviews suggests stacked stigma exists with respect to cigarette smoking. Poor prognosis and disparity in advocacy efforts emerged as stigmatizing events that are linked with smoking stigma, particularly in the arenas of support groups, patient-matching programs, availability of resources, and the lung cancer population itself. Emotional phenomenon resulting from this stigma experience may increase the illness burden for people with lung cancer and explain the variance in distress levels among people with different cancer diagnoses.